Diabetics might have some bad news.
All medications come with side effects, ranging from mild to life-threatening, which can affect a user’s health journey and determine whether they need additional medications to manage side effects.
A recent study found that common diabetes medications trigger a cascade of prescriptions that force older adults to take medications to treat the side effects of other medications.
An estimated 40 million people with diabetes could be prescribed medication to manage their blood sugar levels.
Published in BMC Medicine, researchers analyzed two large routine healthcare databases of more than 387,000 participants to determine how often people with type 2 diabetes are prescribed another medication to manage the side effects of the first medication.
The researchers looked at whether one medication was more often started later than another.
Of 12 drug combinations examined, researchers identified seven potential prescribing cascades, or the addition of a second unnecessary drug to manage side effects that are mistaken for a new medical condition.
Two common diabetes medications – sodium-glucose cotransporter-2 (SGLT2) inhibitors and thiazolidinediones – have been identified in these prescribing cascades.
SGLT2 inhibitors prevent the kidneys from reabsorbing glucose into the bloodstream, eliminating extra sugar through urine, with reported side effects like more frequent peeing and dizziness.
Since inhibitors increase urination and sugar in the urine, the risk of yeast infections also increases.
Researchers found that sodium-glucose cotransporter-2 inhibitors were often followed by antibiotics for urinary tract infections, antifungals, and medications for overactive bladder.
Meanwhile, thiazolidinediones help the body use insulin more efficiently, with side effects such as swelling in the legs and ankles or weight gain, as well as an increased risk of bone fractures, heart failure, liver damage, or hypoglycemia.
Those taking thiazolidinediones were often prescribed loop diuretics, or “water pills” that help the body get rid of excess salt and water by increasing urination.
Other medications commonly used to treat diabetes have also been found in prescription cascades, including statins.
Statins can cause lower urinary tract symptoms and sleep disturbances, leading to the subsequent prescription of overactive bladder medications or hypnotics.
Meanwhile, calcium channel blockers, often prescribed to manage high blood pressure in diabetics, can cause swelling in the lower extremities.
The study found that these medications were often followed by a prescription for diuretics to manage swelling.
Rather than prescribing a potentially unnecessary second medication, researchers suggest that recognizing adverse drug reactions could lead to stopping or changing the first medication.
This, in turn, could reduce the amount of work patients have to put into treatment and the number of medications they have to manage.
Gn Health
